| NPI | 1912478132 |
|---|---|
| Former Name | NONE NONE NONE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2018-12-16 |
| Last Update Date | 2024-06-26 |